Deans' stroke musings: Hand focused upper extremity rehabilitation in the subacute phase post-stroke using interactive virtual environments

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, April 25, 2021

Hand focused upper extremity rehabilitation in the subacute phase post-stroke using interactive virtual environments

Notice the extra 10 hours of intensive training vs. usual training, not a valid comparison.

Hand focused upper extremity rehabilitation in the subacute phase post-stroke using interactive virtual environments

Frontiers in Neurology , Volume 11

NARIC Accession Number: J85886. What's this?
ISSN: 1664-2295.
Author(s): Merians, Alma S. ; Fluet, Gerard G. ; Qiu, Qinyin ; Yarossi, Mathew ; Patel, Jigna ; Mont, Ashley J. ; Saleh, Soha ; Nolan, Karen J. ; Barrett, AM ; Tunik, Eugene ; Adamovich, Sergei V. .
Project Number: 90RE5021.
Publication Year: 2020.
Number of Pages: 13.

Abstract:

Article presents the protocol for a study designed to empirically test dosing and timing of rehabilitation interventions. Specifically, the study will assess both the value of intensive, high-dosage training as well as the optimal timing of robotic/virtual reality upper-limb motor training, focusing on the hand, in the first 2 months after stroke. In this single-blinded, interventional study, subjects will be stratified on two dimensions, impairment level (Fugl-Meyer Upper Extremity Assessment) and presence or absence of motor evoked potentials. Stratified block randomization will then be used to achieve a balanced assignment. The early-therapy experimental group will receive in-patient usual care therapy plus an extra 10 hours of intensive upper-extremity therapy focusing on the hand using robotically facilitated rehabilitation interventions presented in virtual environments and initiated 5-30 days post stroke. The delayed-therapy experimental group will receive the same intervention but initiated 30-60 days post stroke. The usual-care group will receive the usual amount of physical/occupational therapy. The dose-matched usual-care group will receive an extra 10 hours of usual care initiated 5-30 days post stroke. The study uses clinical, neurophysiological, and kinematic/kinetic measures, plus measures of daily arm use and quality of life. The primary outcome measure is the Action Research Arm Test, measured at 4 months post stroke. Outcome measures will be assessed to determine whether there is an early time-period in which rehabilitation will be most effective, and whether there is a difference in the recapture of premorbid patterns of movement vs. the development of an efficient, but compensatory movement strategy.
Descriptor Terms: BODY MOVEMENT, COMPUTER APPLICATIONS, DEXTERITY, EARLY INTERVENTION, ELECTROPHYSIOLOGY, LIMBS, MOTOR SKILLS, REHABILITATION SERVICES, ROBOTICS, SERVICE DELIVERY, STROKE.

Can this document be ordered through NARIC's document delivery service*?: Yes.
Get this Document: https://www.frontiersin.org/articles/10.3389/fneur.2020.573642/full.

Citation: Merians, Alma S. , Fluet, Gerard G. , Qiu, Qinyin , Yarossi, Mathew , Patel, Jigna , Mont, Ashley J. , Saleh, Soha , Nolan, Karen J. , Barrett, AM , Tunik, Eugene , Adamovich, Sergei V. . (2020). Hand focused upper extremity rehabilitation in the subacute phase post-stroke using interactive virtual environments. Frontiers in Neurology , 11 Retrieved 4/23/2021, from REHABDATA database.